Domestic Student Health Insurance Plan 2011-12
Aetna Student Health Policy #711146 | To save money on health care, currently enrolled U-M students on the Ann Arbor campus should visit UHS first. Effective February 6, 2012, the Nurse Managed Care locations at North Campus Family Health Service and Community Family Health Center will no longer be providing primary care services or referrals. |
On this page:
- Why buy this health insurance plan?
- Eligibility
- First, go to one of these Preferred Providers
- How to find another Preferred Provider
- Coverage periods, costs and payment
- How to enroll or make payments
- Plan benefits
- Exclusions (what this plan does not cover)
- Definitions
- Student Health Insurance Committee
- Further information, brochures and applications
Why buy this health insurance plan? Students should have health insurance to help cover products and services not covered by the health service fee. Health insurance is not required to receive care at UHS. Many UHS services are covered by the health service fee (part of tuition) when a student is enrolled for classes for the current semester on the Ann Arbor campus. See Who Can Use UHS? for information about eligibility to use UHS and coverage through the health service fee.
Students should have health insurance to help cover costs for:
- Medical care received outside of UHS (for example, emergency room visits, hospitalizations or ambulance service)
- Services not covered by students’ health service fee (including medication, immunizations, orthopedic equipment, eye care and eye wear)
- Medical services for dependents, spouses and domestic partners
Without insurance, fees for these services are the patient's responsibility.
Health care costs are at an all-time high, and unexpected medical expenses can set students back financially. The Domestic Student Health Insurance Plan was developed with student needs and budgets in mind. For example:
- This plan covers you as long as you are a student (or a student's dependent). Age is not a factor in determining eligibility for students.
- If you are away from home or campus, this plan provides coverage including travel health assistance.
- This plan provides prescription drug coverage.
- Coverage periods are consistent with academic semesters.
- This plan is sponsored by the University of Michigan in collaboration with Central Student Government.
Eligibility: This plan is available (subject to verification) to:
- UM students enrolled in classes or between semesters (e.g. during spring/summer session) at the Ann Arbor, Dearborn or Flint campuses, including:
- Graduate and doctoral students who are completing graduation requirements (writing thesis, preparing dissertation, studying for prelims, studying abroad on detatched study, pre-doctoral candidates, etc.)
- International students, students with dual citizenship and visiting scholars who are not eligible for international insurance
- Green card holders who meet the above qualifications
- Eligible spouses, unmarried domestic partners of any gender and children of all the groups listed above
- A UM student enrolled in the Plan who receives an approved medical leave of absence (coverage for medical leave cannot extend beyond one Policy Year past the current year enrolled for classes)
- Age is not a factor in determining eligibility for students, spouses or domestic partners with this plan.
First, go to one of these Preferred Providers to reduce your out-of-pocket expenses.
UM-Ann Arbor - University Health Service: Currently enrolled U-M students on the Ann Arbor campus should visit UHS (207 Fletcher St) first to save money. UHS offers comprehensive outpatient medical services including primary health care, specialty clinics, health support services and health education. Many UHS services are covered by the health service fee when a student is enrolled for classes for the current semester on the Ann Arbor campus. UHS does not provide pediatric (for children ages 10 and younger) or pre-natal (pregnancy) care. See Who Can Use UHS? for eligibility to use UHS and Appointments or Walk-in to arrange a visit.
UM-Ann Arbor: East Ann Arbor Health Center:
4260 Plymouth Road Ann Arbor, Phone 734-647-5715
Provides medical services for infants, children and adults of all ages. Services include general medicine, preventive care, pediatric care, adolescent medicine, women's health care including obstetrics, family planning, geriatric medicine, sports medicine, minor surgical procedures and immunizations and allergy injections. Family Practice physicians staff this center.
Packard Health:
3174 Packard Road, Ann Arbor, Phone 734-971-1073
501 N. Maple Road, Ann Arbor, Phone 734-926-4900
UM-Dearborn Counseling and Support Services provides nursing consultation and referral to community sources of care.
2157 University Center
Dearborn MI 48128
313-593-5430
UM-Flint Urban Health and Wellness Center provides nursing consultation and referral to community sources of care.
303 East Kearsley Street
1153 William S. White Bldg.
Flint, MI 48502-1950
810-424-5269
How to find another Preferred Provider: Call Aetna at 800-242-3721, or go to the Aetna website, click Enter DocFind and follow instructions.
Coverage periods, costs and payment:
| 2011-12 Policy Year | |||
| Coverage Period | A. Annual (See also Payment Option) | B. Winter | C. Spring/Summer |
| Effective Dates | 8/24/11-8/23/12 | 1/1/12-8/23/12 | 5/1/12-8/23/12 |
| Payment Deadline | 9/24/11 | 1/24/12 | 5/24/12 |
| Costs: | |||
| Student only | $2,813 | $1,877 | $947 |
| Student + Adult | $8,130 | $5,423 | $2,719 |
| Student + Adult + Child(ren) | $11,394 | $7,602 | $3,809 |
| Student + Child(ren) | $6,077 | $4,056 | $2,037 |
You can enroll at any time, even if a payment deadline has passed, but costs are neither prorated nor retroactive. Coverage will end August 23.
You can also request a coverage period other than the established Annual, Winter, or Spring/Summer periods. Again, costs are not prorated, and coverage will end August 23. For more information, contact Aetna Student Health, for policy #711146 at 800-242-3721.
Payment option for the Annual coverage period: If you chose the Annual coverage period and paid by 9/24/11, you can make payments. (This option is not available after the 9/24/11 deadline. Insurance coverage may be interrupted if you do not make the second payment by 1/24/12 and for the third payment by 5/24/12 and the pre-existing limitation may apply.)
| Annual Coverage Period with Payment Option (2011-12 policy year): | |||
| 1st payment: | 2nd payment: | 3rd payment: | |
| Effective Dates | 8/24/11-1/31/12 | 2/1/12-5/31/12 | 6/1/12-8/23/12 |
| Payment Deadline | 9/24/11 | 1/24/12 | 5/24/12 |
| Costs: | |||
| Student only | $1,246 | $921 | $646 |
| Student + Adult | $3,592 | $2,669 | $1,869 |
| Student + Adult + Child(ren) | $5,032 | $3,743 | $2,620 |
| Student + Child(ren) | $2,686 | $1,995 | $1,397 |
How to enroll or make payments: Enroll anytime online. Note: eligibility for enrollment is subject to verification. To enroll online:
- Go to the Aetna website.
- You will receive enrollment confirmation via email. Processing pharmacy benefits may take 5 business days following Aetna Student Health's receipt of a complete enrollment form and appropriate premium payment. If you need a prescription filled immediately, contact UHS Managed Care/Student Insurance Office.
Plan benefits: The chart below describes some (not all) benefits. Please note that when you use preferred providers, you save money because preferred providers agree to accept negotiated fees which may be lower than what non-preferred providers would charge. If a non-preferred provider charges more than the reasonable fee allowed, you must pay the difference.
Note: This plan has a Pre-Existing Conditions clause. See Exclusions for details.
| Type of Service: | Benefit Level: | |
| Lifetime aggregate maximum | $1,000,000 per covered accident, injury or sickness | |
| Annual deductible | $250 per Covered Person per policy year (does not apply to prescription drug expenses) | |
| With Preferred Provider: | With Non-Preferred Provider: | |
| Covered medical expenses (co-insurance) Note: annual deductible and copays do not apply to maximum out-of-pocket expense | 80% with $2,500 out-of-pocket maximum limit per Covered Person per policy year | 60% with $2,500 out-of-pocket maximum limit per Covered Person per policy year |
| Physician office visits | Negotiated fee after $15 per visit copay | Reasonable fee after $50 deductible per visit |
| Inpatient hospitalization | Negotiated fee Note: $200 penalty if no pre-certification for hospitalization | Reasonable fee Note: $200 penalty if no pre-certification for hospitalization |
| Emergency room | Negotiated fee after $75 per visit copay (waived if admitted) Note: $200 penalty if no notification for emergency admissions | Reasonable fee after $75 per visit deductible (waived if admitted) Note: $200 penalty if no notification for emergency admissions |
| Outpatient mental health | Negotiated fee after $15 per visit copay | Reasonable fee after $50 deductible per visit |
Prescription drugs Note: Includes coverage for contraceptive drugs and contraceptive aids, prescription smoking deterrents, prescription appetite suppressants and prescription acne medications. | 100% of the Negotiated Charge after: | 100% of the Recognized Charge after: You must pay in advance and seek reimbursement from Aetna Pharmacy Management. For the reimbursement form, click here, then click on Aetna Prescription Drug Claim Form). |
| Vision (to maximum $30 per policy year) | Comprehensive eye examination (although dilation is included only at the UHS Eye Care Clinic - see also UHS Vision Benefit below) with $15 copay (Ann Arbor campus students and dependents must receive exam at UHS Aug 24 - April 30) | For details, read two paragraphs below and/or see Full Plan Details on the Aetna Student Health website. |
Benefits also include well-baby care, allergy care, physical therapy, chiropractors, nutritional counseling, maternity expenses, abortion, discounts at participating health clubs, special rates on alternative therapies, discounted health-related products such as vitamins, Worldwide Emergency Travel Assistance, and unlimited mental health visits. See Full Plan Details on the Aetna Student Health website for additional services and discounts.
The UHS vision benefit includes a comprehensive eye examination including dilation with a $15 copay, to a maximum of $30 per policy year. (This benefit is managed by UHS and is not underwritten by Aetna.) Ann Arbor campus students and dependents must receive service at UHS between August 24 and April 30. Some people (i.e. children under 3 years of age, Ann Arbor students studying out of the Ann Arbor area, Flint and Dearborn students and dependents living outside the Ann Arbor area) may need to use a provider other than UHS. UHS will reimburse for one routine eye exam per policy year (not to exceed $30 per policy year, after a $15 copay per exam, and subject to UHS guidelines). Glasses and contacts lenses are not a covered benefit. For reimbursement, send the original paid receipt (be sure to keep a copy for your records) to the UHS Managed Care/Student Insurance Office. In addition to the annual exam, you can receive discounts on products and services at the UHS Optical Shop and VisionOne® providers.
Worldwide Emergency Travel Assistance: Participants have access to emergency medical assistance provided by On Call International while traveling more than 100 miles from home, anywhere in the world. Benefits include: 24/7 consultation; foreign hospital admission guarantee; prescription assistance; lost luggage assistance; legal and interpreter assistance; and travel information such as visa and passport requirements; travel advisories; natural disaster and political evacuation services; accidental death and dismemberment benefits; medical repatriation and return of mortal remains; etc. You must call 866-525-1956 within the US or 603-328-1956 outside the US to arrange services, as On Call International will not reimburse you if you pay.
Exclusions (what this plan does not cover):
Pre-existing Conditions are payable up to a maximum of $1000 per accident or sickness; this exclusion:
Will no longer apply when the Covered Person has been continuously insured (see Definitions) for 180 consecutive days
Does not apply to prescription medications
Does not apply at the following facilities:
UM-Ann Arbor University Health Service (explore this website)
- Dental services are not covered. For other options:
- UM Dental School offers patient services but not insurance
- Aetna Vital Savings Discount Program offers dental discount plan (choose Dental Discount program from left column)
- Glasses and contact lenses are not covered.
- Preventive care (that is, "physicals") is not covered. (For women, pap smears and gonorrhea and chlamydia screening plus associated visit charges are covered. For men, gonorrhea and chlamydia screening are covered but associated visit charges are not covered.)
For definitions, see Full Plan Details on the Aetna Student Health website.
Student Health Insurance Committee negotiates this insurance plan for students and addresses domestic student health insurance issues. See Student Health Insurance Committee for more information.
Further information, brochures and applications:
- Aetna Student Health, policy #711146, 800-242-3721 (apply online)
- UHS Managed Care/Student Insurance Office, 734-764-5182 or toll-free 866-368-0002 or email mancare-stuins@umich.edu (paper applications available)
- Campus Information Centers at the Michigan Union and Pierpont Commons (brochures only)
- Central Student Government (brochures only)
- For international student insurance, see International Student and Scholar Health Insurance Plan
